How to Survive

during my

Residency in Peds!

What R1 taught us about fluid order

sheets, kangaroo care, Ventolin prn,

VSign and Taco Tuesdays…

Table of Contents

1. WARDS – How to navigate the

world of pink, blue and yellow as a

junior!

2. NICU – A Guide to Neonates for

the Newcomer!

3. PICU – From ABCs to HFNC,

CPAP, ACVG…and beyond!

4. Wellness – Staying well and happy

during residency!

Wards

Wards: where you go from knowing nothing to doing everything!

Welcome to your new home! You will spend 3 months in you first year on wards and

1 month on nightfloat.

As an R1 on the wards, you will gradually gain more responsibility as you

transition from being a junior to senior resident. The wards are more than just

managing patients and their diagnoses; it’s a place where you get to learn how to

present cases, supervise medical students, review admissions and eventually

manage a whole ward team. There are a lot of learning opportunities and awesome

times on the wards, but it can at times be very daunting. This section is designed

to help you remember what's important and how to not wind up in a bed like your

patients…

For your first block, remember that your job as a junior resident is not to

take care of the whole team and list. This is where you learn how to manage your

patient’s individual problems. Keep track of their comorbidities, their medications,

and their day to day wellbeing. Use this ward block to orient yourself: learn where

to find forms, how to call different consultants, how to schedule tests and how to

manage discharge planning. Get used to the flow and learn from your senior about

how to prioritize the daily tasks and how best to manage your team and all you need

to get done. It will be a busy rotation but try your best to read around your cases.

For the second block, take on less patients. The patients you will take on will

be more complex and that will give you the ability to handle patients with multiple

medical issues involving more than one organ system. However, take on more

responsibility in the managerial role as well, by helping medical students, talking to

consultants about patients that are not necessarily yours, and helping to manage

acute situations and participating in the discharge or management meetings of the

patients on your team. This is an exciting time of added responsibility!

For the third block, you’ll find that you may not have any patients, or only 1-

2 complex ones. Your role is to be the senior’s right hand. Talk to your senior about

defining your role, but try to take the team phone and deal with issues and

admissions that come. This can be a gradual process over the 4 weeks so don’t

worry if on week 1 you are not too sure how to get started; your seniors will help

guide you through this. Your role will also include reviewing admissions with the

medical students, taking the lead in morning rounds, and overall managing the flow

of your floor. Make sure you still review everything with your senior and that you

recognize your limitations. You are still learning…it’s all a work in progress so be

kind to yourself!

Sometimes at the Glen, it may happen that there will be two teams instead

of three. If this is the case, expect that you might be two juniors on the same

team. If this happens during your third block, try to work it out with the other

junior and take turns being senior.

For nightfloat, you will be doing two 2-week rotations for a total of 1 month

of nightfloat in R1. For this block you will be buddied up with another R1 (typically

family medicine) and a senior R2 peds resident. You and the other junior resident

will alternate doing admissions overnight. Aside from this however, take initiative

and leave your phone number or pager at the nursing station of one of the wards

and ask to be called if anything comes up. You’ll learn to deal with overnight issues

this way. If you feel comfortable, ask your senior if you can be the manager of one

of the teams. Keep your senior up to date with what is going on, but try and manage

these patients on your own and give report for that list in morning signout.

For your second nightfloat, you can transition to taking calls from the ER

about admissions, reviewing admissions with medical students, and addressing any

problems that are on the wards. It’s a good time to practice because you have a

senior resident in house to guide your clinical decision making and who can help you

practice a more senior role for when you’re in charge the following year.

Tricks of the trade:

1. Expect the unexpected! A day on the wards can go from calm to chaos quickly.

As much as possible, try to plan your day and prioritize tasks (eg. call

consultants as early as you can, arrange an MRI the day before if possible).

2. Leave at a reasonable time when you can. The wards can be a very heavy

rotation and you may not feel tired at first but by the third week you will be

exhausted.

3. Try to keep rounds efficient by driving your team forward. A day on the wards

with endless rounds will make it very difficult to get work done in a reasonable

amount of time.

4. Group calls to similar consultants for your team to limit your time chasing after

them... it will make things easier for your team, and for the consultants.

5. Take advantage of consultants when they are around- they can teach you so

many interesting things.

6. Arrange imaging and call other services (eg. GI, ID, Respirology) before working

on progress notes. Notes can wait until after; what’s more important is to get

the job done. Work on prioritizing – this is a valuable skill to have!

7. Try to get discharges out in the morning before noon to help get work done on

the wards.

8. Prescribing can be scary and complicated sometimes. Take advantage of having

access to the pharmacists (only a phone call away); they are there to verify

your orders and give you tricks toward a safe practice.

9. Prepare your discharge material in advance- it will save you time at the end of

the day.

10. Remember that if you want something to get done, you can do it yourself but

remember that the ward is a team and some people can get things done much

faster than any of us can (ie. the ward clerks are dynamite)!

11. It’s OK to step away from rounds – if you need to call a consultant, put in

bloodwork or imaging requisitions, or address an issue on the wards, go do it.

12. Learn to delegate.

13. Get as much experience dealing with acute issues as you can.

14. Eat during the day, drink fluids and take time to go to the bathroom. It’s very

easy to forget these simple things but it will make you much more efficient and

productive.

15. Take the time to get to know the nurses. We have an amazing team of nurses on

the ward, and the sooner you get to know them, the easier and more fun your

shifts will be!

16. Be open with your senior resident. Try and meet with them early in the rotation

and go over both expectations and goals for each ward block. If you feel like

you can take on more responsibility, don’t be afraid to let them know. On the

other hand, if you’re feeling overwhelmed or that you can’t manage something on

your own, be open and tell them. There’s no shame in asking for help. Always

remember that at the end of the day you both are a team.

NICU

NICU can be one of the most overwhelming (AND REWARDING) rotations. We

don’t mean to scare you with this, rather to provide you with tips that hopefully

can make your first NICU rotation smooth

1. First and foremost: YOU ARE NOT ALONE!

Easily said, but is even more easily forgotten. Remember, there is always

someone there ready to help you out or answer your questions. Residents,

NNPs (who are amazing and know TONS), staff, nurses, RTs... Do not

hesitate to look out for help or call!

2. Ask questions and get exposed!

Don’t worry if you feel lost or do not understand. It is TOTALLY OK NOT to

know things... There are, however, many opportunities to learn. NNPs, staff,

senior residents, RTs, nurses are all great teachers. During orientation on

your first day, you will have many lectures on basics in the NICU, ask your

questions! Run to deliveries, volunteer to assist with the insertion of

umbilical lines, and ask many questions! Please don’t be shy!

- Pharmacists: great resource in regards to fluid sheets and drips

- RT’s: great resource on ventilation and how to approach management

- Nutritionists: great resource on basic fluid and nutrition needs of

newborns at different gestational ages, breastfeeding resource and also

the milk sheet

- NNP’s: surgical procedures and case management

- Senior residents and Staff: ANYTHING (or perhaps tailored…)

3. Know your schedule and try to organize your day accordingly.

You will see, not only is NICU busy but our own schedules are too! Protected

teaching time, RCC, mock codes, lectures... you will feel like there’s always

something interrupting your day. It is fine! Just keep it in mind and

prioritize your tasks, in order to avoid wasting your valuable time. Your day

typically starts at 7:30 in the conference room for handover. You pre-round

from 8-9:00 and at around 9:00 you start rounding with the rest of the

team. You will learn how to present your patients after hearing the nurse’s

handover and make a plan for the day. Rounds usually end around 11-12:00.

The rest of the day is for seeing your patients and writing notes. There are

three separate teams that alternate every day: transport, resuscitation and

consult team during the day and you may be part of one of them.

4. Try to do as much as possible during rounds.

NICU is not only a service where you will learn about Neonatology... but

where you will learn about time management and organization!

Babies are born and being transferred AT ANY TIME! So you never know

when you will be interrupted, called or have to run to the birthing center. So

try to optimize your time as much as you can: Fluid sheets, milk sheets,

orders, notes, can often be either started, updated or even done during

rounds (and you will have nurses, pharmacists and nutritionist there with you

in case you need their help).

However, do not get obsessed: Sometimes it is not possible. But as much as

you can, try to get paperwork done while rounding so you can forget about it

afterwards!

5. Useful resources & where to get your information from.

- The NRP course and textbook are very useful tools in preparing for your

NICU rotation; they are a great place to start as you start to build

knowledge in not only neonatal resuscitation, but also in the management

of acute clinical situations amongst your patients.

- You will also be provided with the NICU USB key with many interesting

protocols and guidelines! You don’t need to learn them by heart, but carry

it with you so you have easy access to useful information.

- Nurses in the NICU are great resources and they really know their

patients well. At the beginning of a night on nightfloat it’s a great idea to

do quick rounds on all your patients and introduce yourself to all the

nurses. Check in to see if they have any pressing concerns, to review the

plan for the night, review the planned blood work for the morning etc.

- Get familiar with flowsheets and charts so you won’t waste time looking

for the information you need during your pre-rounds!

- Ventilation can be a challenging topic to grasp as an R1. Respiratory

therapists are a wonderful resource, on rounds, during the day, and

during nightfloat. They have a lot of expertise on the matter and it can

be a wonderful learning experience to ask them their opinion on

everything from respiratory settings, blood gases, and respiratory status

assessment of your patients.

6. Centricity is a software used to document our assessments when we attend a

birth at the birthing unit. A centricity summary should be done on each birth

that you get called to, regardless of whether the baby is admitted or not.

This summary should be a quick timeline of the steps taken in the initial

steps or resuscitation of the baby. Details that are important to include are:

- Reason you were called to the birth

- Pertinent details concerning the baby and mother (term baby, SVD vs. C-

section, GBS positive but antibiotics covered etc.)

- Whether the baby was vigorous or not

- Crying or not at birth

- Respiratory effort at birth

- Coloring of the baby

- Heart rate – did it always remain above 100?

- Oxygen saturation – did it follow the trend expected for minutes of life?

- Any interventions – which ones and for how long (CPAP, PPV, oxygen)

- State of baby when admitted/returned to mom

- Follow-up plan, if any (ex. CBC on a baby whose mother had a fever during

birth)

Example:

NICU called to term SVD with meconium, mother GBS negative.

Baby was born vigorous and crying. Pink color. Baby was dried, stimulated and

suctioned. Baby’s heart rate stayed above 100 and saturation >95%. Baby was

moving all 4 limbs equally and had good suck. Normal female genitalia. Exam

otherwise unremarkable. Baby was then bundled and returned to mother for skin to

skin. No need for further follow up.

7. Make sure when it’s the best time to examine your patients with their nurses

Babies and nurses will appreciate that you respect their own schedules!

8. Despite your busy schedule, spend some time with babies and their families.

This is probably the most rewarding time of the day And promote

Kangaroo care!

9. And once again, remember: You are not alone.

Feeling overwhelmed and lost at the NICU is something we have all went

through. Talking about it and sharing your feelings does not make you any

less or any weaker. On the contrary, it will help you out releasing any anxiety

you might be experiencing, seeing things differently, finding answers and

getting some perspective!

Things get better with time and you will realize how much you learn with

experience.

PICU

Quick reminders at a glance:

Recognize your own limits, don’t hesitated to ask for help

o PICU fellow - 25652

o Respiratory therapist

o Nurse in charge

Daily progress notes are written on VSign

Start transfer notes early and keep them updated (your nightfloats

will be forever grateful and this will make things much easier & safer

for patients when urgent transfers need to be arranged)

Review your PALS algorithms & carry your PALS card

Familiarize yourself with the basics of mechanical ventilation:

o Mechanical Ventilation Module - http://openpediatrics.org/

Familiarize yourself with the conditions commonly encountered in the

PICU (list below)

Take a look at our inotropic & sedative agents quick guide below

The Unit

Welcome to the Montreal Children’s Hospital Pediatric Intensive Care Unit (PICU).

It is an 18 bed unit (12 PICU beds & 6 ACU beds (step-down unit)). You will be

providing care to acutely-ill children with a variety of medical and surgical issues.

McGill pediatrics residents are among the rare pediatrics residents in Canada who

will have exposure to the PICU in the first year. It is one of the most enriching

learning experiences for residents and you should definitely take this opportunity

to ask as many questions as possible and learn as much as possible with a special

emphasis on the pathophysiological aspect of pediatric pathologies and their

treatments. You will learn to become more comfortable dealing with sick patients,

anticipating problems and recognizing and dealing with a deteriorating patient

early. These skills will be of primordial importance for many of the other rotations

you will be going through during your 3 to 4 years of pediatric residency.

The PICU can seem like an overwhelming environment at first. Don’t worry,

everyone feels this way. We will try in this short document to share with you some

of the knowledge we acquired while rotating through the PICU as R1s as well as

tips/advice we have collected from our fellow R1s as to how you can make this

rotation more pleasurable and manageable.

http://openpediatrics.org/

Residents are primarily responsible for caring for the children that they are

assigned to (anywhere between 3 to 8 patients, occasionally more when it comes to

weekend & night coverage). You are integral members of the team, and are first in

line in diagnosis and implementation of care for your patients, with the obvious

ongoing support, guidance and assistance of PICU fellows (in-house coverage at all

times) and PICU attendings.

There will be two fellows during the day (medical fellow and cardiac fellow) and a

single fellow overnight. Staff physicians are on call for 24hrs but will not usually

be in-house overnight. In addition, a nurse practitioner will usually actively

participate in the care of patients (they are extremely knowledgeable and

experienced, don’t hesitate to ask for their help when you need). A charge nurse is

assigned to coordinate the daily function of the unit and the Nurse Manager

oversees the unit (bed management). The PICU also has a designated social worker,

pharmacist, dietician, physiotherapist, and occupational therapist. Finally, in doubt,

ask and trust your nurses! They know their patients, are extremely knowledgeable

and have excellent clinical judgement.

Typical Day

The typical day in the PICU starts with sign out. Morning sign out is at 8:00 on

week-days and 8:30 on week-ends.

It’s a good idea to have a look at your patient’s most recent lab work in order to be

more efficient during rounds. X-rays will be reviewed during sign out with the

respiratory therapist (RT).

Then, bedside rounds take place with the entire team including residents, fellows,

staff, RTs, nurses, nurse in charge, and pharmacist. You’ll be expected to give a

one liner about your patient to the team. Then, the nurse goes through a system-

based review of the patient’s status/problems. You should then try to come up with

a plan for your patient and suggest it to the team. It forces you to think through

things and commit yourself to decision-making and is the best way to learn. Nobody

will fault you for coming up with a plan they don’t agree with. See it as an

opportunity to develop your autonomy and to have an educational

exchange/conversation with colleagues.

Consultants should be called early (don’t be afraid to get the ball rolling by calling

specialists even during rounds on the spectralink). Do a full exam on all your

patients. You will want to have a baseline exam to be able to better recognize any

change in your patient’s status should you be called to the bedside by a nurse to

reassess a patient. Daily progress notes are done on V-sign, you can either type-in

your exam & impression/plan or fill them in by hand at the bedside. Writing a

problem based impression and plan by hand is often a good idea because it is much

faster and will allow specialists consulting the chart to more easily appreciate the

team’s thought process and plan then trying to decipher the whole VSign summary.

If you are not late, you should sign out your patients to the late resident around 5

PM. If you are the late resident, you will stay until 8 PM and sign out to the night

resident.

The weekend days are a little different only because the team is smaller and you

have a larger patient load. Try to get your notes done early, as you will likely also

have to do consults/admissions during the day.

Typical Night

The typical night in the PICU varies a little bit according to the fellow you are on

call with. You arrive at 8 pm and get a sign out from the late resident and/or the

fellow.

After dealing with any acute issues (admissions, acutely ill patients & post op

cardiac patients), a good way to start the night is to round on all the patients and

introduce yourself to the nurses, ask for a baseline status and get a baseline exam

of the patient to recognize any active issues. This can be done with or without the

fellow depending on their style. Follow-up with any pending things that were signed

out to you by the late resident and then find your fellow and discuss your

impressions & plans for active patients. It is the night resident’s responsibility to

put in X-ray requisitions in Oacis before midnight for the following morning and to

work on transfer summaries/orders for possible next day discharges. You will

round more formally with the fellow and nurse in charge around midnight to make

sure the plan is clear for the night and the fellow will then often head to bed if

things are quiet and controlled. They remain in-house and on the unit and will be

happy for you to call if you have any concerns or questions.

Tips and Tricks:

- Never hesitate to ask for help from the fellow overnight. They want to know

everything relevant! Always better to err on the safe side and ask.

- Don`t take it personally if nurses call the fellow directly if they are worried,

their main concern is the patient’s safety and if they are acutely concerned

they will bypass the middleman to get the quickest response possible.

- Do introduce yourself to nurses though so they know who you are and feel

that you are more actively involved. They will then feel more comfortable

coming to you for help.

- Do try to make a plan with the fellow before they go rest on how they want

you to follow up on active issues or with specific lab tests (i.e. when do they

want to be called).

- Make sure you have snacks and water to keep yourself going! It will often be

difficult for you to leave the unit to get food or drinks.

- Make sure you sleep during the day. Some nights get busy! However, if

things are quiet and you are done with your whatever you had to do, don’t be

afraid to catch a few hours of sleep.

- When doing the discharge/transfer notes, try to see it as a learning

opportunity and read around the cases. For example, what was the working

diagnosis, why did they do certain investigations or start/stop antibiotics or

other therapies, etc. It will also make for a better transfer note and your

ward buddies will be grateful!

- Make sure to ask for a good sign out. Fellows know all the patients on the

back of their hand but the PICU daily notes are not always detailed. Don`t

waste too much trying to read through all those VSign notes…

- It may be OCD, but if you can combine the PICU/ACU lists on Oacis and try

to keep up with new results (labs & imaging) by removing all bolded/red

items. Makes it easier to see new results (especially abnormal results) when

they come out.

PICU Admissions

PICU admissions can come from the ER or from the wards. All PICU

admissions/consults should go through the fellow. If you get called directly by

mistake, make sure you let the fellow know what was signed out to you and what

they want you to do about it (often you’ll end up seeing the consult/admission first

without the fellow, unless acutely ill or new ER patient). The admissions notes are

typed on a new system template (shortcut found on the desktop) and are always

system based. You only get the relevant past medical & family history but don’t

need to dive into it as extensively as for admissions to the wards. PICU admissions

are better when more targeted and concise, you want to focus on the acute issues.

Of note, nurses & RTs often like to know the patient’s weight early on to prepare

the admission and crash sheet, certain medications, and start setting up the

ventilator! Often, if a patient is sick enough to warrant a PICU admission, you

should stay by their side until they make their way to the unit.

Common PICU Pathologies you should familiarize yourself with:

Coagulopathy (DIC)

Diabetic Ketoacidosis

Electrolyte disturbances

Intoxications

Meningitis/Encephalitis

Respiratory failure

o Acute Respiratory Distress Syndrome

o Bronchiolitis

o Status Asthmaticus

o Pneumonia

Shock

o Cardiogenic Shock (Arrhythmias, Myocarditis, CHD, Cardiomyopathy)

o Distributive Shock (Sepsis, Anaphylaxis, Neurogenic)

o Hypovolemic Shock (Hemorrhage/Trauma, Fluid loss/Dehydration)

o Obstructive Shock (Pneumothorax, Tamponade, PE, LVOT obstructive

lesions)

Pneumothorax

Pericardial tamponade

Status Epilepticus

Traumatic Brain Injury/Increased Intracranial Pressure

Quick Guide to Inotropes

Agent Dosage Mechanism of Action Effect (s)

Dobutamine 2-20

g/kg/min

1-agonist

(predominantly)

2-agonist

-antagonist

cardiac contractility & HR

HR & SVR

SVR

Dopamine 2-20

g/kg/min

1-agonist (5-

15g/kg/min)

2-agonist (5-

15g/kg/min)

-agonist

(>15g/kg/min)

cardiac contractility & HR

HR & SVR

SVR

Epinephrine 0.1-1

g/kg/min

Dose-dependent -

agonist

1-agonist

2-agonist (low dose)

Heart Rate

cardiac contractility & HR

HR & SVR

Norepinephrine 0.1-2

g/kg/min

-agonist

1-agonist

SVR

cardiac contractility (HR

blunted by SVR)

Milrinone 0.25-0.75

g/kg/min

PDE3 inhibitor cardiac contractility, SVR,

improved diastolic function,

little effect on HR

Quick Guide to Sedatives

Agent Dosage (Bolus) Dosage

(Infusion)

Comments

Opioids Analgesia, sedation, amnesia

Respiratory depression

Histamine release (pruritus,

vasodilation)

N/V, constipation, urinary

retention

Morphine PO: 0.15-

0.30mg/kg

IV: 0.05-

0.1mg/kg

IV: 10-

50g/kg/min

Fentanyl IV: 1-2g/kg IV: 1-

5g/kg/hour

100x more potent than morphine

More rapid onset & shorter

duration. Rapid infusion chest

wall rigidity.

Benzodiazepines Sedation, anxiolytic, amnesia,

anticonvulsant

Respiratory depression

Midazolam IV: 0.05-

0.2mg/kg

IV: 0.5-5g

/kg/min

Diazepam PO generally 3-

4x IV

IV: 0.05-

0.2mg/kg

1mg Midaz IV -> 2.5mg Diazepam

PO

Other

Ketamine IV: 0.5-2mg/kg IV 5-20g

/kg/min

PCP derivative (primarily NMDA

antagonist)

Generally maintains BP

Bronchodilation but increases

secretions

Dexmedetomidine IV: 0.2-0.7g

/kg/h

Steroid-sparing agent

Short acting 2-agonist

Vasodilation (BP) & HR

Clonidine PO: 0.5-

4mcg/kg q8h

PO equivalent of Dexmedetomidine

Helpful adjunct in Tx withdrawal

The Postop Cardiac Patient

You will not be expected to care for children in the immediate post-operative care

following cardiac surgery. However, it is a good idea to be at least somewhat

involved in a few of these cases during your rotation. There is a lot to learn about

postop cardiac pathophysiology and it is very useful to gain confidence and comfort

in dealing with these sick patients. There is a PICU fellow assigned to cardiac

patients during the day, ask them how you can help out and pull out as much

teaching from them as you can.

Below is a simple, general approach for the assessment of the postop cardiac

patient:

1. Things you should know:

a. The heart disease diagnosis – This is necessary to understand the

hemodynamic alterations presented before surgery, whether it is a

cyanotic or acyanotic heart disease, if there is pulmonary overflow

and if the heart disease is simple or complex

b. The procedure performed – This will help you understand what

hemodynamic alterations have occurred and which monitoring

parameters are expected postop

c. Anesthesia – Ventilation details (intubation or ventilation difficulties),

types of anesthetics used (pharmacology may affect myocardial

function postop), vasoactive drugs used, blood products

d. Intraoperative events – Arrhythmias, need for shock/CPR, hypoxemia,

surgical complications, injury to

myo/pericardium/pleura/peritoneum/thoracic duct

e. Associated diagnoses or diseases

2. Approach to assessment (postop cardiac ABCs)

A. Airway

B. Breathing

C. Circulation

A. Arrhythmia

a. Familiarized yourself with the different arrhythmias that may

be expected postop for different surgeries

b. Pacemaker settings (ask fellows & staff for basic tutorial)

B. Bleeding (Check drain output)

C. Cardiac output

a. Perfusion & u/o

b. NIRS (Near-infrared spectroscopy): look at trend, not absolute

number

c. Mixed venous saturation (SvO2): how much O2 is extracted

from blood by organs (normal 60-80%); if CO is low then more

O2 extracted from RBC and SvO2 will be lower

The McGill MedWell office:

“Mission: The Faculty of Medicine’s MedWell office is dedicated to

supporting medical learners throughout their training by creating,

promoting and sustaining a culture of wellness and resilience within

the learning environment.”

https://www.mcgill.ca/medwell/aboutus

medwell@mcgill.ca

Tel: (514) 398-5836

Office Hours: Monday-Friday 9am-5pm

Locations:

1. Meredith Annex

3708 Peel Street

Montreal, Quebec H3A 1W9

2. 3647 rue Peel

Montreal, Quebec H3A 1X1

Ways to Get Involved!

The MCH Peds Resident Leadership Guide; includes

committees from Athletics, to Mentorship, to Social

Activities and Wellness. These committees are

created for residents, by residents…here for you to

participate in, help lead, and enjoy!!

https://www.mcgill.ca/medwell/aboutus

Annual Retreat

Every year our entire resident group is excused from all

clinical duties for two days in order to attend our annual

retreat. This past year we headed up north to the beautiful

Esterel Resort where we participated in financial and

mindfulness sessions, went dragon boat racing, relaxed at the

spa and fostered beautiful friendships.

Positivity Board

Check out our positivity board and message board in the

resident lounge where we post favorite quotes, encouraging

messages to each other, and little reminders to laugh and

smile. We hope this little addition to your morning routine and

on your way to your locker makes a difference in your spirit.

How we Stay WELL!

Ordering from Chef on Call and Boustan during

nightfloat!

Taco Tuesdays after teaching!

Wellness afternoons, with free ice cream, puppy

therapy and yoga!

Team dinners, lunches and breakfasts while on the

ward!

Talking to each other about our challenges,

successes, worries…residency is an adventure

worth sharing!

Our WhatsApp Group Chats – where we update

each other not only on where to show up on the

first day of a new rotation, but also on trips, life

milestones, and share a joke or two!

Finally, we’re here for you!